What are the pros and cons of having a high deductible?
Asked by: Timmothy Osinski V | Last update: July 21, 2025Score: 4.3/5 (3 votes)
What is the downside to having a high-deductible?
Cons. Higher deductible: If your deductible is higher, it means you are required to pay for your medical care out of pocket up to that amount before your health plan begins to help pay for covered costs. The exception is for preventive care, which is covered at 100% under most health plans when you stay in-network.
Why is it not a great idea to have a high-deductible?
Large medical expenses: Since HDHPs generally only cover preventive care, an accident or emergency could result in very high out-of-pocket costs. Future health risks: Because of the costs, you may refrain from visiting a physician, getting treatments, or purchasing prescriptions when they're not covered by your HDHP.
Is it better to have a higher deductible?
Low deductibles are best when an illness or injury requires extensive medical care. High-deductible plans offer more manageable premiums and access to HSAs. HSAs offer a trio of tax benefits and can be a source of retirement income.
What are the disadvantages of a deductible?
- The insured will be required to pay off the medical expenses, even if they do not have the resources to bear the cost. ...
- In case of a higher deductible, the insured will be required to pay from their pocket, reducing their savings.
Are High Deductible Health Insurance Plans a Better Choice?
What is too high of a deductible?
In 2023, health insurance plans with deductibles over $1,500 for an individual and $3,000 for a family are considered high-deductible plans.
What are the 3 reasons for deductibles?
- Moral hazard. Moral hazard is the behavioral risk that the policyholder will purposefully seek out insurance payouts. ...
- Reduction of claims.
Is it better to have a $500 deductible or $1000?
Remember that filing small claims may affect how much you have to pay for insurance later. Switching from a $500 deductible to a $1,000 deductible can save as much as 20 percent on the cost of your insurance premium payments.
Do copays count towards deductible?
No. Copays and coinsurance don't count toward your deductible. Only the amount you pay for health care services (like the medical bill you receive) count toward your plan's deductible.
Do you get your deductible back if you're not at fault?
Yes, if you have to pay your deductible and you were not at fault, you may be able to get it back from the at-fault driver's insurance company. This is called subrogation. Your insurance company will pursue the at-fault driver's insurance company to recover the money paid for the damages, including your deductible.
Why would someone choose a high deductible plan?
HDHPs have higher out-of-pocket costs than LDHPs. So, this type of plan is best for healthy people who expect little to no healthcare expenses. If this outlines your scenario, the HDHP's lower premium will likely save you more money than you would spend on medical care.
Is $5000 a high deductible health plan?
For families, the deductible has to be at least $2,700, with a $13,500 max out-of-pocket. Many high deductible plans actually have a much higher deductible ($5,000-$7,000).
How much does a doctor visit cost with a high deductible health plan?
A rough guide is: New Patient Office Visit: $200 - $450 depending on how much time is spent on evaluation and/or how many medical conditions are addressed. Subsequent Office Visits: $75 - $300 depending on how much time is spent on evaluation and/or the number of medical conditions being addressed.
Is it better to have HDHP or PPO?
HDHPs can be a good form of insurance for the young and healthy — especially if your employer offers you HSA contributions. But for anyone with significant medical expenses, an upcoming surgery, or a serious health condition, a PPO could be a better fit because of the lower deductible.
Why do companies push high deductible health plans?
Although a high deductible may sound like a bad thing, in some cases, it makes financial sense. By opting for a higher deductible, employees can secure lower monthly premiums. This makes coverage more affordable, and it can be particularly appealing to young workers who do not expect to have major health issues.
What is the average high deductible?
HDHPs may have a higher annual deductible than traditional health plans. For 2021, an HDHP in the FEHB Program has a minimum annual deductible of $1,400 for Self Only coverage and $2,800 for Self Plus One/Self and Family coverage (the deductible amount is indexed every year).
What if I need surgery but can't afford my deductible?
In cases like this, we recommend contacting your insurance, surgeon, or hospital and asking if they can help you with a payment plan. Remember that your surgery provider wants to get paid so they may be very willing to work with you on a payment plan.
What is considered a good deductible for health insurance?
A plan that has a deductible of at least $1,400 (for individuals) or $2,800 (for a family) is considered a high-deductible plan. If your insurance plan has a low deductible, this means you may reach the threshold earlier and get cost-sharing benefits sooner.
Why do doctors bill more than insurance will pay?
It is entirely due to the rates negotiated and contracted by your specific insurance company. The provider MUST bill for the highest contracted dollar ($) amount to receive full reimbursement.
Do I pay my deductible to the Body Shop?
You typically pay your car insurance deductible after your car is fixed. Depending on your insurer and the situation, your insurer may pay the repair shop directly, minus your deductible — if that's the case, you'll need to pay the repair shop your deductible.
Do you have to pay deductible if not your fault?
If your coverage includes a Direct Compensation and Property Damage (DCPD) deductible, you must still pay the DCPD deductible even if you are not at fault.
Does having a higher deductible lower your insurance premiums?
The higher a deductible, the lower the annual, biannual or monthly insurance premiums may be because the consumer is assuming a portion of the total cost of a claim.
Why do people choose a high deductible plan?
Advantages of an HDHP
HDHPs are popular because they have low monthly premiums. Because the premiums are lower than other health insurance plans, the deductible is higher. However, many HDHPs provide 100% in-network coverage for preventive services before you meet your deductible.
What is the most common deductible?
$500 is the most common car insurance deductible. Not every type of car insurance coverage uses a deductible. A higher car deductible can lower your insurance premium.
What are the pros and cons of having a higher deductible?
High deductible health plans can be a great option for healthy individuals and families who don't need a lot of medical care. They offer lower monthly premiums and tax benefits through HSAs. But, if you need a lot of medical care, high deductible health plans can be expensive.